Talking to Otolaryngologists Who Placed Themselves on Front Lines of the COVID-19 Vaccination Effort

The approval of COVID-19 vaccines in late 2020 and early 2021, coupled with the subsequent immunizations of healthcare professionals, has allowed for a welcome flood of physicians and nurses offering to volunteer in the nationwide vaccination effort.

To gain a clear picture of the experience itself, however, there’s nothing like a first-person account. ENTtoday spoke with two otolaryngologists from opposite ends of the country who recently placed themselves on the front lines of the COVID-19 vaccination effort: Nina Shapiro, MD, director of pediatric otolaryngology and a professor of head and neck surgery at the David Geffen School of Medicine at UCLA in Los Angeles; and Eugene Ross, MD, head and neck surgeon, 2006 Bronze Star Medal recipient, and recently retired partner of the WestMed Medical Group in White Plains, N.Y. Both of the doctors were fully immunized prior to their volunteer experiences.

A Passion for Vaccine Advocacy

Nina Shapiro, MD, is a familiar name to many who follow mainstream media. With more than 20 years of clinical and academic medicine experience, the Harvard Medical School alumnus has appeared on multiple CNN, NPR, and network broadcasts to comment on medical stories in the news, and her work has been published in the Los Angeles Times, The Wall Street Journal, and The Washington Post, among many others. She has contributed to more than 80 peer-reviewed publications and more than 200 scientific presentations, both nationally and internationally. She’s also the author of Hype: A Doctor’s Guide to Medical Myths, Exaggerated Claims, and Bad Advice – How to Tell What’s Real and What’s Not (St. Martin’s Press, 2018). A New York native, Dr. Shapiro lives in Los Angeles with her husband and two children.

ENTT: What led you to volunteer in the COVID-19 vaccination effort?

NS: I have a very strong interest in vaccine advocacy from a public health standpoint as well as a professional standpoint. Even throughout the research process I was very keen on staying current on the vaccine trial data, and later advocating for their safety and efficacy and emphasizing how critical they are—not just for each individual, but for the community.

ENTT: How did you make the time to volunteer?

NS: At the time that the vaccination efforts were gearing up in Los Angeles County, a lot of the hospitals were on a partial shutdown. During the post-winter holiday COVID-19 surge, our hospital, as well as many others, had a severe reduction in non-emergency and non-urgent surgeries. So, when these vaccine sites became available, I decided to sign up to volunteer. I would have done it anyway, but the timing was perfect. I did just one day, which is what most people here do because it’s really hard to get a clinical volunteer spot. Hundreds of clinicians are eager to help, so these spots get filled for a month out quite quickly. People really love to do it.

ENTT: Where did you volunteer, and what was the site like?

NS: I volunteered at a mega-POD—a mega-point-of-dispensing site for vaccination administration. By definition, a mega-POD dispenses at least 1,000 vaccinations a day. I thought about going to the one at Six Flags Magic Mountain in Valencia, Calif., because it just sounded cool to go to an amusement park during such a dark time, but I’m actually happy that I went to California State University, Northridge (CSUN) instead. Like most mega-PODs, it was drive-through: People stay in their cars, the vaccinators come and administer the vaccine through an open window, and then the people drive to a waiting area where they stay for 15 minutes afterward (30 minutes if they have a history of allergic reactions or other specific concerns) to be monitored. Most of the people I saw stayed for 15 minutes.

ENTT: What was the physician volunteer role?

NS: At the CSUN site, nurses gave the vaccines and physicians were responsible for monitoring the patients. We were given an emergency toolbox, which contained a blood pressure cuff and a stethoscope, along with an EpiPen and an intramuscular Benadryl injection, and we literally just walked from car to car, checking on people, asking how they were feeling. At first the physicians sort of grumbled about that because it sounded less exciting and less important than actually giving the vaccines, but it’s really a critical part. There were some mild reactions that, as a physician, I needed to address. It was an important role, and it felt good to do it.

ENTT: What kinds of vaccine reactions did you handle?

NS: One person became very flushed—she had already left the mega-POD and had to drive right back in. Some people felt warm or a little nauseated or dehydrated, but I think this was probably secondary to having been in the car for a long time on a warm and maybe overwhelming day. Some said they were having trouble getting a deep breath, but they actually could breathe just fine. I think they were overwhelmed with emotion—I saw most of that in the last few hours of the day when the car line was slowing down.

ENTT: Is there anything about the people you saw that stands out in your mind?

NS: I remember one gentleman who was driving and had already gotten his immunization—I’d say he was in his mid to late 60s—and in the back seat was his father, who was well into his 90s. It was just lovely to see this family there, getting protected and staying safe. Overall, what struck me was that it was a fairly well-to-do socioeconomic group in general. It felt like a very singular demographic slice of Los Angeles County. It was a very clear message about the realities of vaccine access, at least in the early weeks of the vaccination roll-out. The people that I saw had access to computers, had been able to navigate the sites (which are very difficult), and had the transportation and time to get it done.

Seeing the benefits of [vaccination] has been wonderful, but I’ve also seen the resistance, the reluctance, and the difficulties in access. It was driven home to me how this pandemic has affected different demographic groups extraordinarily differently. —Nina Shapiro, MD

ENTT: What’s your biggest takeaway from this experience?

NS: I felt that the demographics I saw spoke to the inequities of the entire pandemic, let alone the issue of disparities and inequities in care and access to healthcare in general. We’re seeing this being played out in the vaccine effort. Vaccine advocacy has been a passion of mine for a long time, and I’ve been very vocal about it in books, podcasts, TV, and op-eds. Seeing the benefits of it has been wonderful, but I’ve also seen the resistance, the reluctance, and the difficulties in access. It was driven home to me how this pandemic has affected different demographic groups extraordinarily differently.

A Natural Activist

The career of Eugene Ross, MD, speaks to this recently retired otolaryngologist’s personal determination and overall spirit of citizenship. The New York native, who graduated from and completed his residency at Mount Sinai in Manhattan, had built a thriving practice when it was cut short by a disabling spine disease that resulted in 11 herniated disks. He was compelled to retire from medicine in his mid-40s, but eight months after the surgery to fuse four vertebrae in his neck, a recovered Dr. Ross decided to pursue a law degree. He graduated from New York University Law School three years later, and was an attorney at Skadden, Arps in Manhattan for two years before recovering enough to return to medicine.

Dr. Ross had been serving on the faculty of Montefiore Medical Center/University Hospital in New York City on the morning of Sept. 11, 2001. He was among the hospital staff who waited on that day for the wounded who never came. (“The one truism of 9/11 is that you either died or escaped—there was nothing in between,” he recalled.) He went down to ground zero to volunteer as a first responder and was subsequently recruited by the U.S. Army, where he served first as an otolaryngologist at West Point and then as head and neck surgery commander in Iraq from 2005 to 2006, leading the surgical team that worked on ABC News correspondent Bob Woodruff’s face and neck after the reporter suffered a traumatic brain, face, and neck injury when his vehicle hit a roadside bomb near Taji.

In 2007, Dr. Ross joined the Westchester Medical Group in New York and remained there until the March 2020 pandemic lockdown that prompted his decision to retire. In early 2021, the father of three began volunteering to administer the COVID-19 vaccine at vaccination sites in and around Middlesex County, New Jersey, where he resides with his wife.

ENTT: Looking at your history, you’ve somehow managed to be at the scene of several major events. Do you consider your COVID-19 volunteer effort an extension of a life pattern?

ER: I tell people that I’m the living Forrest Gump! Yes, I’ve had a very rich career. I’m just a natural activist, and carrying out my citizenship matters to me. I was naturally inclined to go down to Ground Zero after 9/11, I was inclined to join the army and help out, and I’m inclined to become a soldier in this COVID-19 war because this is the main event now: getting the country vaccinated before things really go downhill. There are vaccines and there are arms, and you need vaccinators to bring them together.

ENTT: Where and how often do you volunteer?

ER: I’m working for the Middlesex County Health Department in New Jersey, volunteering three or sometimes four days a week. I’ve gone to four different sites; by the end of March I will have worked at seven sites.

ENTT: Do you find it challenging?

ER: There’s no technical difficulty. If you’re a head and neck surgeon, you can certainly inject a vaccine. Speed is the only issue. I vaccinate about 40 people an hour, and the shift is about eight hours. It’s more tiring than challenging—I’m not a kid anymore! There was one day when we had about 1,000 patients come through for vaccination, and I myself saw 300 people.

ENTT: Is there any one patient who stands out in your mind?

ER: There was a very rare patient whom I turned away, a 92-year-old whose daughter brought her in for her second vaccine. Her lips had swelled a little bit with her first injection, and I could just envision her having an airway blockage after the second. Even if she didn’t die from that, at 92 she might die from the epinephrine that we would have to inject. So, I refused her and said she would need to set up an appointment in a hospital setting.

I’m inclined to become a soldier in this COVID-19 war because this is the main event now: getting the country vaccinated before things really go downhill. There are vaccines and there are arms, and you need vaccinators to bring them together. —Eugene Ross, MD

ENTT: What was required for you to sign up to volunteer?

ER:  To volunteer, you need to have been retired for fewer than five years, licensed to practice in the state, and in good standing. I’m still actively licensed in New York and used to practice in New Jersey, so they could reactivate my license or grant me a temporary license for New Jersey by endorsement from an active license. All they had to do was call Albany; it took 15 minutes for me to get a temporary license.

ENTT: What did you notice about the logistics of the vaccine rollout?

ER: One of the problems is the sporadic and inconsistent nature of our networks for delivery of public health. The first two vaccines required a lot of logistical and storage capital, and there were limits in New Jersey. But we’re 45 miles from Manhattan, and Rutgers University and Princeton are nearby, so we’re not in the sticks. Fortunately, the Middlesex County Health Department is really good, and the volunteer coordinator is really diligent and communicative. The devil is in the details, and the mechanism on the ground here is good. I’ve seen a positive side of public health.

ENTT: What makes you continue to volunteer when you’ve already worked for so many years and contributed so much?

ER: I had a long career that I really enjoyed, and I was glad to conclude it. But I still want to be productive, and what matters now is that we’re trying to vaccinate 2.5 million people a day. So I’ve inserted myself into the mix. I imagine how I would feel right now if I weren’t doing this and instead just watching when I knew I had two good hands to help. My motivation is a mixture of need, opportunity, and capability. I’ll do this as long as they’ll put arms in front of me.

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Linda Kossoff is a freelance medical writer in West Hills, Calif.